经内镜证实的300例功能性消化不良症状特点剖析  

Analysis of clinical characters in 300 patients with dyspeptic symptoms confirmed by upper gastrointestinal endoscopy

作　　者：吴改玲[1] 柯美云[1] 

机构地区：[1]中国协和医科大学中国医学科学院北京协和医院消化内科,100730

出　　处：《中华消化杂志》2003年第9期533-535,共3页Chinese Journal of Digestion

摘　　要：目的　剖析功能性消化不良 (FD)与器质性消化不良 (OD)的临床特点 ,评价我国消化不良的诊治流程。方法　调查 30 0例经内镜证实的OD和FD各亚型的上腹部消化不良症状 ,并分析各组症状和进餐的关系。结果　FD和OD分别占 5 1.0 %和 4 9.0 %。FD患者更多见于≤ 4 0岁组 (P =0 .0 0 6 ) ,FD的上腹胀、嗳气症状计分明显高于OD(P <0 .0 5 )。而OD患者的上腹痛症状计分则明显高于FD(P<0 .0 5 ) ,有明显的报警症状 (P =0 .0 0 3)。FD和OD两组的症状以空腹为主和以餐后为主的百分比相近。FD的动力障碍样型、溃疡样型和不特定型的症状可表现为以空腹为主或餐后加重。结论　消化不良特征有助于判断FD和OD ;无论是FD或OD患者 ,消化不良症状均可能与酸相关或动力障碍相关。因而 ,根据症状与进餐的关系有助于消化不良的诊治。Objective To investigate clinical characters of functional dyspepsia (FD) and organic dyspepsia (OD) and evaluate the Chinese management guideline of dyspepsia. Methods Three hundreds patients with epigastric dyspepsia symptoms received a series of examinations including a detailed investigation of symptoms, liver functions, upper gastrointestinal endoscopy and B ultrasound, and then they were divided into OD and FD groups in accordance with Rome Ⅱ criteria. Results 153 (51.0%) and 147 cases (49.0%) were ascribed to FD and OD respectively. FD occurred more often at the age of less than 40 ( P =0.006). The scores of such symptoms as bloating( P <0.05) and belching( P <0.05) were higher in FD than in OD, whereas the scores of abdominal pain ( P <0.05) and obvious alarming symptoms ( P =0.003) were lower in FD than in OD. The percentage of symptom relief or exacerbation after the meal was similar in OD and FD groups. Patients with dysmotility like, ulcer like and non specific FD may show symptoms which either predominantly occurred during the fasting or postprandial period. Conclusions Characters of dyspepsia may be helpful in evaluation of FD and OD. Regardless of FD or OD, dyspeptic symptoms could be related to acid or dysmotility, suggesting that the relationship between symptoms and meal may be used to guide the management of dyspepsia.

关 键 词：内镜 功能性消化不良 临床特点 评价 诊断 治疗 流程 罗马Ⅱ标准 

分 类 号：R57[医药卫生—消化系统]